Treatment of delayed union and nonunion of the scaphoid.

Background. Lack of proper union in scaphoid fractures - particularly in the form of pseudarthrosis - is a complication that continues to be an object of concern for orthopedic surgeons. Treatment failures result from non-union or osteoarthritis. Material and methods. In the years 1998-2005 we treated 31 patients in our clinic for delayed union or non-union of the scaphoid. Corticocancellous bone graft (the Matti-Russe method) was performed in 23 cases, the Beck operation in 4 cases, and proximal resection in another 4. Results. We achieved union in every case of delayed union, in 19 cases after the first operation, and in 2 cases after revision procedures. Conclusions. Treatment by corticocancellous bone graft gives good results in the medium and distal part of the scaphiod. In the proximal part it is better to treat by revascularization.